Opposite white matter abnormalities in post-infectious vs. gradual onset chronic fatigue syndrome
Poster No:
100
Submission Type:
Abstract Submission
Authors:
Qiang Yu1, Richard Kwiatek1, Peter Del Fante1, Anya Bonner1, Vince Calhoun2, Grant Bateman3, Takashi Yamamura4, Zack Shan1
Institutions:
1Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia, 2Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA, 3Department of Medical Imaging, John Hunter Hospital, Newcastle, NSW, Australia, 4National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
First Author:
Co-Author(s):
Vince Calhoun
Georgia State University, Georgia Institute of Technology, Emory University
Atlanta, GA, USA
Georgia State University, Georgia Institute of Technology, Emory University
Atlanta, GA, USA
Takashi Yamamura
National Institute of Neuroscience, National Center of Neurology and Psychiatry
Kodaira, Tokyo, Japan
National Institute of Neuroscience, National Center of Neurology and Psychiatry
Kodaira, Tokyo, Japan
Introduction:
While post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) manifest similar symptoms, it has long been suspected that different disease processes underlie them (Chu et al. 2019; Cortes Rivera, 2019). However, the lack of biological evidence has left this question unanswered. Prior DTI studies on ME/CFS have identified white matter abnormalities, yet they have yielded inconsistent findings (Josev et al. 2023; Kimura et al. 2019; Thapaliya et al. 2021; Zeineh et al. 2015). These discrepancies lead us to postulate that ME/CFS is a heterogeneous illness. This study investigated white matter DTI characteristics in ME/CFS patients, and we hypothesised that PI- and GO-ME/CFS are associated with distinct white matter impairments.
Methods:
In this study, we recruited PI-ME/CFS and GO-ME/CFS patients based on consensus diagnoses made by two experienced clinicians and compared their DTI features with those of rigorously matched healthy controls (HCs) with sedentary lifestyles (Shan et al. 2022). The study was approved by University of the Sunshine Coast Ethic committee (A191288) and registered with The Australian New Zealand Clinical Trials Registry (ACTRN12622001095752). The standard FSL FDT (FMRIB's Diffusion Toolbox) pipeline was used to preprocess the diffusion data (Smith et al. 2004). The Wilcoxon rank-sum test (ref) was used to compare the demographic data and behavioural scores between groups. Tract-based spatial statistics (Smith et al. 2006) was used to perform voxel-wise group comparisons of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between patients and HCs for ME/CFS-PI [43 ME/CFS-PI (mean age 42.58 ± 12.41 years; 37 females)] and 43 HCs [(mean age 40.19 ± 8.29 years; 37 females)] and ME/CFS-GO [33 ME/CFS-GO (mean age 42.03 ± 12.87 years; 26 females)] and 33 HCs [(mean age 42.18 ± 7.35 years; 26 females)] studies. Multiple regression analysis was also conducted to examine the relationship between DTI metrics and five clinical measures of 36-item Short-Form (SF-36) mental component summary, SF-36 physical component summary, global Pittsburgh Sleep Quality Index score, Bell's disability scale score, and disease severity. Sex, age, body mass index, metabolic equivalents, Hospital Anxiety and Depression Scale (HADS)-depression, and HADS-anxiety scores were included as nuisance covariates in all analyses. The significance was determined by family-wise error corrected p < 0.05 with threshold-free cluster enhancement at the voxel level.
Results:
PI-ME/CFS participants showed significantly higher (p < 0.05) AD in association and projection fibres compared to HCs (the top half of Fig. 1). Higher AD in PI-ME/CFS was significantly related to worse physical health (p < 0.05) (the bottom half of Fig. 1). In contrast, GO-ME/CFS participants exhibited significantly decreased (p < 0.05) AD in the corpus callosum (the top half of Fig. 2). Lower AD in GO-ME/CFS was significantly associated with worse mental health in commissural and projection fibres (p < 0.05) (the bottom half of Fig. 2). No significant group differences were found for FA, MD, or RD.
·Fig. 1. Diffusion MRI results in post-infectious ME/CFS (PI-ME/CFS) study.
·Fig. 2. Diffusion MRI results in gradual onset ME/CFS (GO-ME/CFS) study.
Conclusions:
This study provides significant insights into the white matter alterations in ME/CFS patients, distinguishing between those with post-infectious (PI-ME/CFS) and gradual onset (GO-ME/CFS). The findings highlight distinct patterns of AD changes in these subgroups, with PI-ME/CFS patients exhibiting increased AD in various association and projection fibres and GO-ME/CFS patients showing decreased AD in commissural fibres. These results suggest different white matter microstructural abnormalities between the two subtypes of ME/CFS and indicate that AD may serve as a sensitive indicator of white matter pathology.
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 1
Modeling and Analysis Methods:
Diffusion MRI Modeling and Analysis 2
Keywords:
Infections
Neurological
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
Other - Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
1|2Indicates the priority used for review
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